Uterine fibroid has become common among younger women and not older women alone as it used to be in the past, a gynaecologist, Dr Fred Achem, said.
Achem who is the President, Society of Gynecology and Obstetrics of Nigeria (SOGON), said this in an interview with the News Agency of Nigeria in Abuja recently. He described uterine fibroids as non-cancerous growths of the fibre and the muscles of the womb. He said: “we have not found an exclusive reason why some womb grows and other wombs don’t grow fibroids.
“But it is known that those who have fibroids are usually those who have to delay in getting their first babies; those who have their babies between 18 and 25 don’t seem to have fibroids that early.
“And over the years this has not been the trend, there has been a bit of a change, we are beginning to see fibroids earlier in women.
“It is still something that research has to pinpoint: a single or multiple number of causes that together predispose a young lady to fibroids. “
He said although a lot of fibroids did not show symptoms, the more severe ones gave signs such as heavy and irregular menstruation and a visible lump on the abdomen.
“A lot of them may not show at all and a lot of women may never know that they have fibroids, these are the friendly fibroids.
“They are gradually growing quietly and slowly in the womb, they don’t hinder conception, they do not manifest as the others do.
“So, a lot of time you do a caesarian operation and see fibroids in the womb. A lot of them are without symptoms.
“The common way they present is usually heavy periods, suddenly the periods begin to last longer and begin to get heavier than they used to be and they are changing more often than they ought to change. “That’s one major way, substantial way fibroid shows, “Others begin to notice a lump, a mass in their stomach, in the abdomen and this is a mass she can feel, her husband can feel or the doctors can feel.
“Such masses are not viable to be felt until the womb is the size of a three-month old pregnancy, so if the fibroids are less than that size, you may never show a mass in the abdomen, “Achem said.
DEFINITION: Fibroids are the most frequently seen tumors of the female reproductive system. Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 50 percent of women of reproductive age have fibroids, although not all are diagnosed.
CAUSES: While it is not clearly known what causes fibroids, it is believed that each tumor develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of the influence of estrogen.
WHO’S AT RISK: Women who are approaching menopause are at the greatest risk for fibroids because of their long exposure to high levels of estrogen. Women who are obese and of African-American heritage also seem to be at an increased risk, although the reasons for this are not clearly understood. Research has also shown that some factors may protect a woman from developing fibroids. Some studies, of small numbers of women, have indicated that women who have had two liveborn children have one-half the risk of developing uterine fibroids compared to women who have had no children. Scientists are not sure whether having children actually protected women from fibroids or whether fibroids were a factor in infertility in women who had no children. The National Institute of Child Health and Human Development is conducting further research on this topic and other factors that may affect the diagnosis and treatment of fibroids.
SYMPTOMS: Some women who have fibroids have no symptoms, or have only mild symptoms, while other women have more severe, disruptive symptoms. The following are the most common symptoms for uterine fibroids, however, each individual may experience symptoms differently. Symptoms of uterine fibroids may include:
Heavy or prolonged menstrual periods
Abnormal bleeding between menstrual periods
Pelvic pain (caused as the tumor presses on pelvic organs)
Low back pain
Pain during intercourse
A firm mass, often located near the middle of the pelvis, which can be felt by the physician
In some cases, the heavy or prolonged menstrual periods, or the abnormal bleeding between periods, can lead to iron-deficiency anemia, which also requires treatment.
TREATMENT: Since most fibroids stop growing or may even shrink as a woman approaches menopause, the health care provider may simply suggest “watchful waiting.” With this approach, the health care provider monitors the woman’s symptoms carefully to ensure that there are no significant changes or developments and that the fibroids are not growing. In general, treatment for fibroids may include:
Hysterectomy: Hysterectomies involve the surgical removal of the entire uterus. Fibroids remain the number one reason for hysterectomies in the United States.
Conservative Surgical Therapy: Conservative surgical therapy uses a procedure called a myomectomy. With this approach, physicians will remove the fibroids, but leave the uterus intact to enable a future pregnancy.
Gonadotropin-releasing Hormone Agonists (GnRH agonists): This approach lowers levels of estrogen and triggers a “medical menopause.” Sometimes GnRH agonists are used to shrink the fibroid, making surgical treatment easier.
Anti-hormonal Agents: Certain drugs oppose estrogen (such as progestin and Danazol), and appear effective in treating fibroids. Anti-progestins, which block the action of progesterone, are also sometimes used.
Uterine Artery Embolization: Also called uterine fibroid embolization, uterine artery embolization (UAE) is a newer minimally-invasive (without a large abdominal incision) technique. The arteries supplying blood to the fibroids are identified, then embolized (blocked off). The embolization cuts off the blood supply to the fibroids, thus shrinking them. Health care providers continue to evaluate the long-term implications of this procedure on fertility and regrowth of the fibroid tissue.
Anti-inflammatory Painkillers: This type of drug is often effective for women who experience occasional pelvic pain or discomfort.